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Friday, January 22, 2016

Owner and Manager of Three Miami-Area Home Health Agencies Convicted in $57 Million Health Care Fraud Scheme

The owner and manager of three Miami-area home health agencies was convicted late yesterday for his role in a health care fraud scheme that resulted in the submission of false and fraudulent claims to Medicare.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Division and Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

Khaled Elbeblawy, 39, of Miramar, Florida, was convicted after trial of one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to defraud the United States and pay health care kickbacks.

According to evidence presented at trial, Elbeblawy was the manager of Willsand Home Health Agency Inc. and the owner of JEM Home Health Care LLC and Healthy Choice Home Health Services Inc., all of which were home health agencies in Miami-Dade County. The evidence showed that between January 2006 and May 2013, Elbeblawy and his co-conspirators used the three companies to submit approximately $57 million in false and fraudulent claims to Medicare that were based on services that were not medically necessary, were not actually provided and were for patients who were procured through the payment of kickbacks to doctors and patient recruiters.

The evidence introduced at trial showed that Medicare paid approximately $40 million on those claims.

The FBI and HHS-OIG investigated the case, which was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Southern District of Florida. Assistant Chief Nicholas Surmacz and Trial Attorney Vasanth Sridharan of the Criminal Division’s Fraud Section are prosecuting the case, and former Trial Attorney Andrew Warren assisted in the prosecution.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.